Sally A. Cevasco v. HHS - Influenza, ulnar nerve lesion, left upper limb (2025)

Sally A. Cevasco, born in 1957, filed a petition for compensation on April 18, 2023, alleging that an influenza vaccine administered on January 11, 2021, caused a lesion of her left ulnar nerve.

Ms. Cevasco received the vaccine at a Walgreens Pharmacy, administered by Justin Costa.

Shortly after the vaccination, she experienced numbness in her left hand. She reported this to the pharmacist and later contacted her primary care physician, Dr.

Uma Kolli, who recommended she see a neurologist. Ms.

Cevasco saw neurologist Dr. Megan Callahan on March 1, 2021.

Dr. Callahan diagnosed a "lesion of [the left] ulnar nerve, left upper limb," noting mild weakness in her left fingers and decreased sensation in her left ring and small fingers.

Dr. Callahan's initial assessment suggested the vaccine was correctly placed and unlikely to have caused direct injury to the ulnar nerve, but later noted in follow-up records that the ulnar neuropathy had "sudden onset with flu vaccination." Nerve conduction studies performed on May 7, 2021, confirmed Ms.

Cevasco suffered from a left ulnar neuropathy. The Secretary of Health and Human Services disputed Ms.

Cevasco's claim, arguing she had not provided sufficient evidence, particularly an expert report, to support causation. Both parties retained experts: Dr.

Bodor for Ms. Cevasco and Dr.

Donofrio for the Secretary. Ms.

Cevasco's petition proceeded as an off-Table claim, requiring her to prove causation-in-fact under the Althen standard. Dr.

Bodor proposed a theory that the vaccine was injected into the teres minor tendon, causing pseudo ulnar neuropathy, and that the diagnosed ulnar neuropathy at the elbow was incidental. He rejected direct nerve trauma due to the needle's length and the absence of immediate pain, and immune-mediated reaction due to the rapid onset of symptoms.

Dr. Donofrio questioned the proximity of the teres minor tendon to the deltoid muscle where the vaccine was administered and found Dr.

Bodor's dismissal of the confirmed ulnar neuropathy as incidental to be unpersuasive. The Special Master, Christian J.

Moran, reviewed the expert reports and arguments. The public decision does not describe the specific dollar amount of any award or annuity, as Ms.

Cevasco's petition was denied. The Special Master found that Ms.

Cevasco failed to establish the second prong of the Althen test, which requires a logical sequence of cause and effect. While Dr.

Callahan's records noted a temporal association between the vaccination and the onset of symptoms, this was not considered sufficient proof of causation. Crucially, Ms.

Cevasco's primary symptom was numbness, not the pain described in the literature supporting Dr. Bodor's theory (Escobar article), and her nerve conduction studies confirmed an ulnar neuropathy, which Dr.

Bodor dismissed as incidental, a conclusion the Special Master found unpersuasive, contrasting with Dr. Donofrio's view that it was "bold to call the ulnar neuropathy at the elbow incidental in the setting of 3 abnormal EMGs." Because Ms.

Cevasco failed to establish a logical sequence of cause and effect, her petition for compensation was denied. Petitioner counsel was Elizabeth M.

Muldowney, and respondent counsel was Alec Saxe. The decision was issued on June 17, 2025.